James Aswathy, Karandikar Sharad, Baijal Shobhit
Colorectal Surgery, Heart of England NHS Foundation Trust, Birmingham, West Midlands, UK.
BMJ Case Rep. 2018 Sep 23;2018:bcr-2018-224876. doi: 10.1136/bcr-2018-224876.
The patient presented to the ear, nose and throat clinic with failed conservative treatment of persistent right otitis externa. On examination, the roof of the right ear canal was polypoid and the tympanic membrane could not be visualised. There was a fragile mass noted in the external auditory canal (EAC) which on microsuction started to bleed. CT internal auditory meatus and MRI internal auditory meatus identified soft tissue mass in the EAC. The patient underwent urgent examination under anaesthetic of the ear and biopsies were taken. He had a background of ascending colon cancer; Duke's C1, pT4, N1 M0, R0 resection and had undergone laparoscopic right hemicolectomy with adjuvant chemotherapy, in the previous year. The biopsy results proved that the mass in the EAC was due to metastatic deposit of colorectal primary tumour. The patient also had a full body CT which revealed other new metastases. The patient is being treated with palliative chemotherapy.
该患者因持续性右外耳道炎保守治疗失败，前往耳鼻喉科诊所就诊。检查发现，右耳道顶部呈息肉样，鼓膜无法看清。在外耳道（EAC）发现一个易碎肿物，经微吸后开始出血。内听道CT和内听道MRI检查发现EAC内有软组织肿物。患者接受了紧急耳科麻醉检查并进行了活检。他有升结肠癌病史；杜克分期C1，pT4，N1 M0，R0切除，前一年接受了腹腔镜右半结肠切除术及辅助化疗。活检结果证实，EAC内的肿物是结直肠癌原发肿瘤的转移灶。患者还进行了全身CT检查，发现了其他新的转移灶。患者正在接受姑息性化疗。
